Dehydrated Human Amnion/Chorion Membrane (Placenta) Reduces Anastomotic Leaks after Esophagectomy

The Annals of Thoracic Surgery
Daniel L MillerWilliam R Mayfield

Abstract

An anastomotic leak is a potentially fatal complication after esophagectomy. Various surgical techniques and reinforcement materials have been applied to eliminate this complication. Recently, we introduced dehydrated human amnion/chorion membrane (dHACM) placenta allograft reinforcement of an esophogastrectomy anastomosis. We retrospectively reviewed prospective data of consecutive patients who underwent an esophagectomy after neoadjuvant chemoradiation to determine if placenta reinforcement reduces esophageal anastomotic complications. From August 2016 through March 2018, we performed 28 open Ivor Lewis esophagectomies, 16 patients (57.1%) underwent placenta reinforcement (PR) and 12 omental reinforcement (OR). The majority of the 28 patients were men (78.5%) with a median age of 61 (42 - 79). Anastomotic technique was modified Orringer in all patients. There was no postoperative mortality. OR patients had more complications and longer hospitalization. One of the PR patients (6.3%) developed an anastomotic defect without mediastinal contamination, while 3of the OR patients (25.0%) experienced an anastomotic leak. The one PR patient with the small anastomotic protuberance was prophylactically stented. The three OR leak patient...Continue Reading

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